Tuberculosis of Kidneys and Genital Glands

The tuberculosis of kidneys, testicles or ovaries (genital glands) is always secondary to primary lesion in the lungs, lymph glands or bones. The tuberculosis of kidneys may occur in early adult life. In the beginning it is commonly confined to one kidney but can spread to second kidney if chemotherapy is delayed. If the disease is not detected and treated well in time, it may spread to urinary bladder. In addition to low grade fever in the evening, feeling of general weakness and loss of appetite, it has three additional symptoms: increased frequency of urination, painless hematuria or passage of red blood cells or blood in the urine and a feeling of dull pain in the lower back or region of loin. The 'tubercular toxemia' is there. The treatment with anti-tubercular drugs is must to avoid surgical nephrectomy.

The tuberculosis of testicles or ovaries (genital glands) is also a serious manifestation of pulmonary tuberculosis. Initially there is swelling of one testicle in the male patient which can be easily felt. Later on it may transform into 'cold abscess' and a sinus is produced. Such patients show highly reactive 'tuberculin test'. The diagnosis is not difficult in a case of 'tuberculosis of ovary'. The swelling of the ovary can be palpated by experienced gynaecologist or can be detected by abdominal ultrasonography. The diagnosis can be confirmed easily by 'fine needle aspiration cytology' (FNAC). The signs and symptoms of 'tubercular toxemia' are there as stated in the case of tuberculosis of kidneys. The treatment with anti-tubercular drugs is must to avoid surgical removal of testicle or ovary.

The treatment begins with active anti-tubercular therapy by the use of at least three drugs and a longer course of treatment may be required in these cases. Surgical treatment will be required if the medical treatment alone is not capable of controlling the disease. If the disease is unilateral in one kidney or one testicle and there is no arrest of the disease with medical treatment, these organs would have to be removed surgically with informed consent of the patient.

To read more about ‘tuberculosis of lymph glands’ just click the following link: http://ntips4u.blogspot.in/2014/03/tuberculosis-of-lymph-glands-common.html

What causes Pyelonephritis and How Serious is It?

The pyelonephritis is said to be very serious renal disease. The well documented cause of pyelonephritis is an infection of interstitial (intertubular) tissue with pyogenic bacteria, most frequently E. coli and Staphylococci, and sometimes Proteus vulgaris and Pseudomonas pyocyaneus. In almost 66% of cases the infection could be secondary to the urinary tract infection and in 33% of cases the infection could be primary through infection of blood. The ascending infection of kidney or kidneys from the urinary tract is quite common in infants. There could be ascending infection of kidneys in pregnant women and also in women with the cancer of the cervix. In the elderly male patients, the ascending infection of kidneys is possible if their prostate is enlarged and the urethra is obstructed causing partial or full retention of urine. Irrespective of the sex of the patient, the obstruction plays a vital role in causing the infection of kidneys. It has been proved through experimental study on rabbits that the obstruction of urinary system was the main cause of renal infection and pyelonephritis. In man infection of blood may cause unilateral or bilateral pyelonephritis depending on the obstruction. The obstruction may be functional or organic. The ultrasonography or the serial radiographical study is required to rule out the obstruction.

The pyelonephritis in its chronic form is very dangerous disease. The kidney may become a bag of pus due to infection with pyogenic bacteria cited above. The condition is also called pyonephrosis. A pure hydronephrosis (nephrosis caused due to back pressure of accumulated urine) in an advanced stage may become infected. The kidneys get much enlarged due to hydronephrosis or pyelonephritis. There is possibility of complete erosion of functional architecture in side the kidney due to pyogenic infection. Pyelonephritis may also develop in a gradual manner with little frank suppuration. The early detection of disease could be better for the patient as it could be treated effectively.